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TIMETABLE- the KEY FACTOR
If you suspect early onset of AMD a test on the Optical Coherent Tomography unit (OCT) will produce 3D imaging pictures of the interior of the eye. This is a set of pictures and numbers to enable a retinal specialist make decisions on treatment. This modern technology is the proverbial leap forward. The data is not just available quickly, but provides an amount of information far greater than a generation ago. Can be digitally transmitted to a remote site for assessment, although artificial hurdles may be put in place for no good reason.If WET AMD is indicated it is vital to confirm the diagnosis inside 7 days. If confirmed, treat within a further 7 days. (Per RCO). It is important to understand the need to push for this to done. It is your sight and quality of life that is at risk- possibly your employment and income as well. The clock is now ticking.
If your Optometrist suspects WET AMD the RCO protocol calls for the Optometrist to refer directly to a retinal specialist and not the GP, but currently there is no retinal specialist on island. IOM currently refers to A&E, then to non-retinal specialist and only then to a retinal specialist. Past objections regarding false positives are no longer reasonable, given that the modern OCT scans made in the practice can be emailed to the retinal specialist, provided the recipients unblock receipt- removing two non-productive administrative layers of referral to meet RCO recommendations.
If treatment continues to be available only in the UK, as opposed to on-island, this makes keeping the timetable quite difficult. The Manx Macular Group has been pressing for on-island treatment for some time, not only for the all-important clinical timetable, but also to save the patients the gruelling travel. Currently a typical day is a very early start to catch the early plane to Liverpool, attend for examination and/or treatment at the hospital- returning by the last plane at night. With the travel to and from the airport this adds up to a very hard day. Sadly it is known that some patients have opted out and given in to their condition as they have found the travel experience so hard. See UPDATE NOVEMBER 2013 for bad news on this front.
With the recent reports from the UK that they are are falling well short of the treatment timetable and unlikely to be able to improve quickly, plus news that airline travel may be less available, there has to be an advantage in saving the travel costs to fund provision of on-island treatment. With the proposed fortnightly clinic provided by a team flown in, the timetable would always be met and patient travel reduced to a road journey- home to clinic and back- certainly not an all day exhausting experience. A telephone query to Liverpool early November 2013 could only access a recorded message that there was a 7-8 week delay. Clearly this cannot enable conformity to the RCO timetable.
The key to successful treatment is to keep the delay between first indicators and diagnosis/treatment inside the period laid down by the Royal College of Ophthalmologists. (RCO) People in the zone described in ‘CAUSES’ should adopt a self-test habit using the AMSLER chart. At the first sign of problems, the first call is to your Optometrist at your usual Opticians Practice. Ideally you should already be attending annually for a routine examination.